There's more than one!

Simon and I were very excited about our first baby scan at 11 weeks.  We couldn't wait to see our little one for the first time. Just before the scan started Simon told the OB that my sister has triplets so it would be interesting to see if we were having twins (or more!). I confidently told the OB that we were just having one baby thank you very much! As soon as the scan started Simon and I could see a baby and something else.... The OB announced "There's more than one!". There was a lot of nervous laughter and exclamations such as "no way!", "really?", "are you sure", “there’s only 2 right?”, etc. My legs started to shake as the shock set in. Almost straight away the OB told us he thought there was no dividing membrane and they looked like what are called monoamniotic twins. He then spent a while trying to work out whether they were conjoined.  I think I almost fainted.  He said he was sure that they were not conjoined but explained that this type of twinning is extremely high risk. Suddenly our low risk singleton pregnancy had turned into something very different.....

  

Treatment Plan

My OB refused to tell me the mortality rate (well, that’s telling you something!!!).  I reviewed the research myself and no one agrees on what the mortality rate is or the best way to manage this type of pregnancy because it is so rare and not much research has been done.  It is routine in the US for mothers to be admitted to hospital for inpatient monitoring from viability but that is not the case in Australia and I did not go inpatient.  I had regular high resolution scans that increased with frequency towards the end of my pregnancy.  I worked until I was 28 weeks pregnant and then I was on (self imposed) bed rest until delivery.

Coping with a High Risk Pregnancy 

I didn't know whether I was going to have 2, 1 or 0 babies in my future so it was hard to know whether to be happy, anxious, sad or....just feel nothing. I didn't know whether I should have a baby shower. Celebrating their impending birth when their chances of survival weren't great was a little odd.

I made a decision to try to be optimistic and ignore the horrible statistics. My babies were healthy according to the scans and I'm healthy so there's no use worrying! I hated people telling me to not get my hopes up and telling me not to buy baby furniture until after they were born. I wanted to pretend there were no risks - that's how I coped. My OB would tell me all the risks at every appointment leading up to viability which depressed me every time. Once I reached 26 weeks he became more optimistic and told me he was confident I would make it to the magic 32 weeks.

However, reality would set it, especially when we went for scans. I had 10 high resolution scans that took 1-2 hours each. I had a panic attack at every scan (a real one – I’m not exaggerating!). The first one was the worst - I had to take 6 breaks in one hour. From then on I closed my eyes for the majority of the time and I distracted myself by eating and drinking. Even after the sonographer assured me she had found 2 heartbeats I would still be very, very anxious. Seeing them was extremely emotional and overwhelming. All of the scans came back with excellent results. The flow of blood from the placenta to the babies was always good which reassured us that any knots weren't restricting the flow of nutrients.

However, good scan results didn't guarantee that we were going to take home two babies. My husband and I had a few awful but necessary conversations about what we wanted to do if one or both didn't make it. We had a plan in place and we had even picked out special names. Not that we didn't want to use "Phoebe" and "Sophia" but we wanted special names with meanings that were appropriate for the situation.

The Final Countdown

During the last 4 weeks of my pregnancy I had weekly scans and OB appointments. The last two scans showed that Sophia, the smaller girl was quite a bit smaller than Phoebe and had not grown much in the 33rd week. Week 33 I had an appointment with a different OB as mine was on holidays. This other OB told me with confidence that I would make it to 34 weeks and both babies would be fine. I asked him over and over again at the last appointment whether Sophia was going to be ok because I was so worried about her but he said she would be fine.

I tried not to obsess too much about feeling the babies move but I couldn't help making sure I felt both of them kick each day towards the end. The problem with babies in the same amniotic sac is that it is very hard to tell which baby is kicking and whether it is just one or two kicking! I would sometimes wake in the middle of the night just wishing the babies would move. So I would get up, walk around and eat something just to feel them move. Once they got going I tried to relax again and go to sleep. However, it is hard going to sleep with two babies all excited inside you!

We visited the hospital for antenatal classes and asked all sorts of questions - how often can we see our babies, who can touch the babies, how long are they are likely to be admitted for if they are healthy, should I bring clothes/blankets for them, what happens if they need to be transferred to another hospital, which type of breast pumping equipment is available?  I also got a tour of the Special Care nursery to get a feel for the place and I started to picture myself breastfeeding in the feeding areas. All this information helped us to prepare us for what was to come... 

Phoebe and Sophia's Birth Day 

The girls were born healthy via cesarean January 2010 measuring 2008 grams and 2318 grams. Immediately after they were born my OB inspected the umbilical cords and said "someone was looking after these girls". There were several knots in their cords and I believe God was definitely looking after us!

They had APGARS of 9 and were only in humidity cribs for 19 hours. They didn't need continuous O2 but they had breathing apnoea for a week. Apnoea is when they forget to breath and need to be given O2 briefly. They were fully tube fed formula (and a tiny amount of breastmilk) for 3 days and then we started to slowly introduce breastfeeding.  It’s amazing that we had all the risks but ended up with our perfectly healthy children.  We felt truly blessed.  Words cannot describe the relief we felt when they came out screaming. We couldn't stop smiling (except for when I was vomiting from the anaesthetic!).

The substitute OB that saw me the week before the birth rang my OB from Hawaii (he was on holidays!) to ask if my girls were alright. He was quite concerned about whether he had made the right decision to let me have them out at 34 weeks rather than 33 weeks. Turns out he was right but gosh - talk about "obstetrician's bluff!"

Straight after surgery I was able to hold Sophia for about 10 minutes. They would've let me hold her longer but I was feeling very dizzy and nauseous from the anaesthetic and chose to give back Sophia for fear of dropping her! About 2 hours after birth I was wheeled into the special care nursery and got to stroke Phoebe and Sophia's heads for 5 minutes each. My husband took lots of videos and photos of the girls so that I could look at them while I was recovering in my room which helped enormously. I didn't get to hold Phoebe until 29 hours after birth.  The first time I held her was so magical and it brings tears to my eyes 2 years on!  I know some mums don’t get to hold their premmie baby for weeks after birth so I was just utterly grateful it was only 1 day for me.

Our Special Care Experience

We loved special care. Probably because every time we went there we got to see our gorgeous girls! I loved the smell of the antibacterial lotion they make you wash your hands with because I associated it with seeing them. I also loved the smell of the baby shampoo in the nursery and bought a bottle at the pharmacy so I could smell that gorgeous baby scent when I wasn't with them.

Phoebe and Sophia were in special care for 3 weeks. For the first week I was also in hospital and Simon was staying in my room. Simon would visit the girls every 3 hours to feed them through the nasal gastric tube and I mean EVERY 3 hours. He was so in love :). I couldn't go every 3 hours but tried to get there 2-4 times a day. At first we were only allowed to cuddle them every 6 hours but as they gained strength we were able to cuddle them every 3 hours. It sounds strange to restrict physical contact with a baby but it really wore them out. Going home at the end of the first week was hard. We had to leave them behind :(. Every mum has that moment...commonly known as the 3^rd day blues where things get a little emotional.  Well, I had my moment the second time I had to leave the hospital and go home to two empty bassinets.  I was crying uncontrollably and asking why I had to leave them behind.  Luckily a kind nurse and the mother of the little girl next to Phoebe comforted me and assured me they would be well looked after overnight.

At first we came back to the hospital for two feeds a day, then three, then four and then I was in there all day doing 5 feeds during the day. We then stayed overnight at the hospital for 2 nights to show they were able to be fully bottle and breastfed 24/7. We took them home at 4 weeks old.  When they came home they were pretty easy to look after.  They fed, they pooped, they slept.  Yes, there wasn’t much sleep for mum or dad but they were content most of the time.  Little did I realise that this was the “easy” stage!!!  I will leave the reflux, colic, RSV, gastro, bottle and breast refusal, overtiredness, overstimulation, etc. for my personal blog :).  I really wish someone had told me about silent reflux - it's so common in preemies! 

Two Years On

My girls are now loud, vivacious 2 year olds that are just like every other two year old...except there’s two of them of course!  You would never know they were a high risk pregnancy or premature.  They are healthy and happy - we are so incredibly blessed.